Abstract
Purpose :
The purpose of this study is to assess change in visual outcomes and graft survival for patients undergoing corneal transplantation (PKP, DSAEK, UT-DSAEK, DMEK) with a previous history of glaucoma surgery compared to those with a history of glaucoma without glaucoma surgery.
Methods :
This is a retrospective single center, case-control study. 71 consecutive patients (mean age = 72.3 ± 14.8 years, M:F = 1.1) who underwent corneal transplantation procedures with a history of glaucoma filtering surgery (trabeculectomy and/or tube shunt) compared to 83 controls (mean age = 72.1 ± 13.9 years, M:F = 0.89) at the University of Ottawa Eye Institute. Patient demographics, surgical technique for corneal transplantation, indication for transplantation, donor endothelial cell density (ECD), death to enucleation and graft times were recorded. The primary outcome of the study was number of letters gained from baseline to 12 months. Secondary outcome was incidence of graft failure and time to graft failure. Analysis was conducted using t-test and chi-squared test with a significance level of 0.05.
Results :
Overall, the proportion of patients in each corneal transplant group was as follows: 23 (14.9%) PKP, 70 (45.5%) DSAEK, 9 (2.6%) UT-DSAEK and 52 (33.8%) DMEK. No difference was observed between the two groups with respect to graft status including donor and recipient age, donor ECD, and death to enucleation and graft times (p > 0.05). No difference was observed between the two groups with respect of IOP control at baseline (p > 0.3) and at 12 months follow up (p > 0.05). Baseline BCVAs were 1.56 ± 0.62 LogMAR and 1.26 ± 0.76 LogMAR for the case and control groups respectively (p = 0.01). BCVA was improved significantly from baseline to follow-up at 12 months in both case (p = 0.02) and control (p < 0.01) groups. There was no difference in the number of letters gained from baseline to 12 months between the two groups (p >0.05). Average time to graft failure was 10.6 months, with better overall graft survival rates in the control group (78.3%) compared to the case group (59.2%) (p = 0.01).
Conclusions :
Although there was no difference in the number of letters gained between the two groups at 1 year, patients with pre-existing glaucoma surgery had worse pre-operative BCVA and overall corneal graft survival rates compared to patients with pre-existing glaucoma on medical therapy.
This is a 2021 ARVO Annual Meeting abstract.